Hurley Katrina F, Ducharme James
Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
CJEM. 2008 Jan;10(1):75-80. doi: 10.1017/s1481803500010046.
A 21-year-old man with Marfan syndrome and known aortic root aneurysm presented to our emergency department with symptoms suggestive of acute aortic dissection. The patient was hemodynamically stable and bilateral upper extremity blood pressures were similar. There was no mediastinal widening on portable chest radiograph. Both contrast CT and retrograde angiography of the aorta failed to identify dissection. Subsequent transesophageal echocardiography demonstrated a Stanford classification type A dissection. This case demonstrates the utility of multiple imaging modalities for identifying aortic dissection in high-risk patients.
一名21岁患有马凡综合征且已知有主动脉根部瘤的男性因提示急性主动脉夹层的症状前来我院急诊科就诊。患者血流动力学稳定，双侧上肢血压相似。便携式胸部X线片显示无纵隔增宽。主动脉的增强CT和逆行血管造影均未能发现夹层。随后经食管超声心动图显示为斯坦福A型夹层。该病例证明了多种影像学检查方法在识别高危患者主动脉夹层中的作用。
